Respiratory Syncytial Virus (RSV) is a very common respiratory virus that displays mild cold like symptoms in adults and older children. In children under two, particularly those born prematurely, are immunocompromised, as well as those with heart and lung disease, RSV can be a potentially life threatening disease. RSV commonly occurs in epidemics in the winter and early spring. Pathophysiology

RSV is a highly contagious virus and is related to Para influenza, mumps and measles (Cooper, Banasiak & Allen, 2003), which almost every child will have had by the age of three. Reoccurring infections of the disease are very common. There is "a high association between hospitalized infants with bronchiolitis and the development of asthma" (Cooper, et. al, 2003 p.453). RSV is a large contributing factor to wheezing and lower respiratory tract problems in childhood. (Cooper, et. al, 2003) "The incubation period for RSV is usually 3-6 days but may vary from 2-8 days. The virus enters the body usually through the eye or nose, rarely through the mouth. The virus then spreads along the epithelium of the respiratory tract, mostly by cell to cell transfer. As the virus spreads to the lower respiratory tract, it may produce bronchiolitis and/or pneumonia. Early in bronchiolitis, a peribronchiolar inflammation with lymphocytes occurs, which progresses to the characteristic necrosis and sloughing of the bronchiolar epithelium. This sloughed necrotic material may plug the bronchioles resulting in an obstruction to the flow of air, the hallmark of bronchiolitis. Air may be trapped distal to the sites of occlusion, causing the characteristic hyperinflation of bronchiolitis, which, when absorbed, results in multiple areas of focal atelectasis." (http://virology-online.com/viruses/RSV.htm, p.1-2) "The course of the illness is variable, lasting from one to several weeks. Most infants show signs of improvement within 3 or 4 days after the onset of lower respiratory tract disease" (http://virology-online.com/viruses/RSV.htm, p.2). RSV is transmitted by close or direct contact with respiratory secretions, droplets or formites. RSV can live on countertops for 30 hours and on hands and clothes for less than 1 hour." (Cooper et al. 2003, p.453). Nosocomial infection from RSV is very common on pediatric wards during the epidemic season. Epidemic season is commonly from November to April with a peak in January or February. Clinical symptoms of RSV are demonstrated in Table 1. Severe cases of RSV are not as common as in adults as they are with children. There have been, however, cases of epidemics in long term care communities with the virus affecting the elderly population. Diagnostic Tests or Lab Findings

There are a couple of different diagnostic tests done to identify a Respiratory Syncytial virus diagnosis. One of these tests would be radiographs of the chest to rule out other respiratory problems. "Radiographic examination findings of bronchiolitis reveal hyperinflation, patchy atelectasis and peribronchial wall thickening and can usually differentiate between pneumonia and brochiolitis" (Cooper et al. 2003, p.454).

The second test that would be done is the "enzyme-linked immunosorbent assay (ELISA) that detects antigens." (Cooper et al. 2003, p.454) This test is accomplished by obtaining a specimen by way of nasal wash. This is the most accurate way of diagnosing RSV.

The third diagnostic procedure would be a CBC or complete blood count, but this is not an accurate tool in the definite diagnosis. A combination of all three tests as well as a thorough history defining exposure and symptoms is the best course in an appropriate diagnosis. Methods of Treatment

The majority of the more mild cases of RSV can be treated at home. Home remedies would include rest and maintaining...

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BRONCHIOLITIS
Andrea Jimenez
La Guardia Community College
SCL 114.4173
Name: Andrea Jimenez Date of Assignment: Thursday, January 20 2014
Directions: Utilize format in preparation for your clinical case study and submit to your clinical instructor. You will be required to present the case study orally during pre and post conferences.
Client Initials: E.S. Client Age: 11 months
Primary Diagnosis: Bronchiolitis, RSV positive
1) Define the etiology of the diagnosis
Bronchiolitis is an inflammation of the bronchioles caused by an acute infection in the lower respiratory track. Different types of microorganism cause this infection, but the most common one is RSV (Respiratory Syncytial Virus). Other microorganisms include parainfluenza viruses type 1 and 3, adenoviruses, rhinoviruses, and Mycoplasma pneumonia.
RSV is a small, labile paramyxovirus that produces inflammation and tigers the creation of mucus. This virus is transmitted by indirect/direct contact with infected sources. Once the test shows positive the patient will be isolated with contact precautions as any nosocomial infection.
2) Describe the growth and developmental tasks ascribed to this age level.
According to Erickson’s theory an eleven-month child will develop optimism, trust, confidence and security if proper care is provided. It is very important to build boundaries with mother/father in the first year of life....

...I. Cause:
* RSV is caused by a virus. It can be spread through droplets when an infected person coughs or sneezes or by contact with the nasal or oral secretions of an infected person, either directly (i.e., kissing) or indirectly (i.e., touching a doorknob).
II. Signs/Symptoms:
* Runny nose
* Decreased appetite and activity level
* Coughing
* Sneezing
* Fever
* Wheezing/Difficulty breathing
* Irritability
III. Incidence:
* Anyone at any age may contract RSV
* Nearly all children will have had RSV by their 2nd birthday
* Hospitalization is rarely required and generally occur in infants under 6 months of age
IV. Risk Factors:
* Premature infants
* Children under 2 years of age that suffer from congenital heart or chronic lung disease
* Children and adults with compromised immune systems
* Adults that are 65 and older
V. Diagnostic Tests:
* RT-PCR assay test of secretions
* Antigen detection testing
* Cell culture
VI. Treatments:
* No specific treatment for RSV
* Hospitalization in severe cases
i. Supplemental oxygen
ii. Suctioning of mucus from airways
iii. Intubation with mechanical ventilation
VII. Prognosis:
* Generally a full recovery in 1-2 weeks
* Can cause death in infants and the elderly (rare)
* May...

...﻿CHAPTER ONE
INTRODUCTION
Human respiratory syncytial virus (RSV) is a virus that causes respiratory tract infections. The Respiratory Syncytial Virus (RSV), discovered in 1956, is capable of causing a broad spectrum of illnesses. In 1956, Morris and colleagues initially isolated RSV from chimpanzees with upper respiratory tract (URT) infections as the causative agent of most epidemic bronchiolitis cases. Subsequently, Channock et al (1956) associated this agent with bronchiolitis and lower respiratory tract (LRT) infection in infants. Since then, multiple epidemiologic studies have confirmed the role of this virus as the leading cause of lower respiratory tract infection in infants and young children. (Lancet, 1999)
Respiratory syncytial virus is one of the viruses that cause the common cold and infections in the upper parts of the respiratory tract. Respiratory syncytial virus is the major cause of lower respiratory tract infections (LRT) in infants and young children, and hospital visits during infancy and childhood. Older children and adults commonly experience a "bad cold" lasting one to two weeks accompanied with fever, nasal congestion, and cough. However, in infants and toddlers, RSV can produce severe pulmonary diseases, including bronchiolitis inside the smallest airways (bronchioles) of the lungs (inflammation of the terminal airways which produces wheezing) and pneumonia (infection of these terminal...